Hope, Health Work and Quality of Life in Families of Stroke Survivor, Article Critique Example

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Article Critique

Relevance of research problem and significance

It is stated in the article by Bluvol and Ford-Gilboe (2004) that stroke is the fourth leading cause of death in Canada and is one of the leading causes of disability. Due to the significance of this, it is relatively important to research the ways families are coping with the after effects of stroke and any disabilities that might result. It is a well known fact that a stroke will cause huge financial and emotional burdens on the individual, his family, and the entire society; however, the support of these caring individuals will play an important role in deciding whether or not stroke victims will be allowed to return home or will have to remain institutionalized in some way.

Due to the overwhelming statistics pertaining to stroke and its victims, it is important to understand how the family feels and consider the implications this life will have on the family if the stroke victim never fully recovers. Therefore, it is relevant to study this problem in order to find the answers and hopefully provide a more positive outcome in some of the more negative situations. This article strives to do that by understanding how the family feels and assessing the situation from that aspect in order to answer questions.

Appropriateness of the conceptual framework

There have been no studies recorded pertaining to stroke survivors and their families, but there are studies pertaining to chronically ill and disabled individuals and the coping strategies they used to improve the quality of their life. The framework of this particular study is appropriate in its concepts because it focuses on the strengths, motivation and resources of the entire family and how to use those factors in a positive way to help the individual who is ill have a better outlook on life and be more willing to engage in the community and its lifestyle rather than sink into depression and further the disease process.

Congruence between research question and methods used

This article used a descriptive correlational, cross-sectional design. It was determined to be the best fit because the relationships between family members were centered around hope, health work, and quality of life and these had not previously been studied in the stroke population from the family’s perspective. The aim of the research was to examine the relationships of stroke survivors living with disability. Four hypotheses were tested based on this aim.

The hypotheses were: there is a positive relationship between hope and health work; there is a positive relationship between health work and quality of life; there is a positive relationship between hope and quality of life; hope and health work predict quality of life. The hypotheses also agreed with the research question and the methods used. Due to the nature of the cross-sectional design, there would be less chance of sampling from too small of a population and the participants would more than likely have an array of various experiences relating to hope and health work in regard to the quality of life and their loved one.

Literature review

The most significant word in the hypothesis for this study is the use of the word hope. It always has some degree of presence in a situation, even if there is only a small amount present. It is thought to have a positive effect on the health of an individual by defining his or her health responses, such as making the necessary adjustments to achieve goals and improving body function as an indirect result. It also can serve as an adaptation mechanism if the individual cannot improve the body function, but realizes this through the process of striving to achieve the goal. It has been studied in populations of individuals with cancer and chronic diseases as well as healthy populations as a psychological mechanism. In this study, hope is of definitive importance if there is going to be any chance of families balancing their lives and adapting to new circumstances with their loved ones. It will also be crucial for the stroke victims as they try to recover as much as possible and reintegrate into the community, albeit in a possibly different manner.

The most significant influences on one’s quality of life have been presented in various literature as depression, functional ability and socialization. Most studies have only included stroke victims with mild to moderate repercussions. There is no data to suggest a difference if the impairments were of a greater severity; thus, this study would be of great value to clinicians in determining those answers.

As for family members and their experiences with stroke victims, literature has placed more emphasis on the negative impact the stroke has caused and the extra burdens placed on the entire family. There have been reports of decreased health amongst family members, strong feelings of burden, stress, and depression in relation to caring for the victim after the stroke and for as long as necessary until the victim is able to return to some form of his former self (if ever).  Although, a few studies did report a positive attitude by mostly female caregivers in relation to caring for the stroke victims. This study will be of vital importance to correlate previous findings due to the cross-sectional nature and the fact there will be interviews with both the stroke victim and the family members. It will help to understand more about the way the incident has and still is impacting daily routines and about how the family members view the future as far as the stroke victim is concerned.

Discussion

As previously stated, this particular study was the first study that explored the relationships between family strengths, behaviors in health, and the quality of life in stroke victims and their families. Although the Developmental Model for Health and Nursing (DMHN) was validated for the stroke victims, only two of four hypotheses were supported with the data from victims’ spouses. Therefore, the theory was not as useful in determining the spouses’ feelings of hope, health work, and quality of life. The positive relationship found between hope and health work for both partners was supported and these results were relatively high.

The results of the study suggested that stroke victims and their families experienced a higher quality of life which was directly proportionate to the amount of hope they innately held. Those families who were more hopeful had a better quality of life. There were no unrealistic expectations, but hope of recovery was there and the reality of adaptation was also there if recovery was not an option. It is important to note that most of the direct caregivers were women and the study suggests this might account for the positive aspect in hope as well as that hope transcending to the victim and helping to compensate for any lack of hope he might have during certain time periods.

The findings in this study are not surprising when one ponders the primary caregiver in most families and the person who is most nurturing when generalizing between males and females. There are instances where males are more prone to be the more nurturing sex, but more often than not, females tend to have more instinctive mechanisms for nurturing and providing care to the sick or bedridden. This would apply to stroke victims. Also, along with the instinctive nurturing ability, the positive attitude likely will reflect outwardly and help the victim adapt and/or recover more quickly than a negative attitude would.

Conclusion

The study performed brings a great deal of information about the promotion of health and issues with quality of life in stroke victims and their families. There is strong support for rehabilitation if at all possible. There can be insight gained from this study due to the message of hope and how adaptation to one’s disability could be a positive thing, even when faced with a lifelong obstacle with no cure.

Implications

It is important to note, any limitations in the study might have implications for rehabilitation therapy with stroke victims and families. It is important, though, to understand that stroke victims and their families might not have the same vision of reality after the stoke has occurred. Because of this, it is crucial for any therapy or interventions to take into consideration the quality of life for both parties. The patient’s quality of life might actually be improved if clinicians can build on the unity of hope and the ability to either achieve their goals with their family’s support or adapt to their limitations with their family’s support. It is crucial for the family to understand this and be willing to fully for this therapy to be successful.

It is also important to remember the economic burden to the family and be sensitive to this when designing treatment options or therapies for the victim. Families are often struggling with medical costs in addition to the burden of caring for the victim. Some form of psychological therapy might be helpful for those family members who seem to not have enough positive thinking to achieve the goals set forth. Community awareness and support can be helpful as well for families in times of need.

Many of the participants in this study felt the need to share more than simply what was on the questionnaire. Therefore, it would be beneficial to have further studies conducted along the same manner as far as the subjects of hope and quality of life with stroke victims and families. Those studies could be more qualitative in nature or even mixed methods in order to further understand any intricacies that might have been overlooked due to the fact this study did not concentrate on each family’s individual story. It would be beneficial for research purposes and would be beneficial for the families to talk through their problems as part of a study while understanding they would be evaluated psychologically on a more in depth scale pertaining to their views on hope, quality of life, and positive feelings in general.

Reference

Bluvol, A., & Ford-Gilboe, M. (2004). Hope, health work and quality of life in families of stroke survivors. Journal of Advanced Nursing , 48 (4), 322-332.

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